Scientific Foundations Committee
May 4, 2012
7:30 – 9:00 am, B-646 Mayo
In attendance: S Allen, R Acton, L Anderson, A Belzowski, A Blaes, H Boyer, J Chipman, B Clarke,
E Coleman, E Eckert, A Edvenson, Fahrenkamp, G Filice, G Giesler, C Hegarty, S Katz, R Kempainen,
K Lee, A Minenko, P Mulcahy, C Niewoehner, J Norrander, D Powell, D Power, Santos, D Satin
P Southern, T Thompson, D Walk, D Wangensteen, K Watson, M Woods
Absent: M Becker, G Giesler, T Mackenzie, J Pacala, M Sanders, L Schimmenti, T Weinhaus,
K Wickman,
Synopsis of May 4th SFC Meeting (see details of full discussions below)
Joint Meeting
Integration
Dr. Jeff Chipman, Assistant Dean for Scientific Foundation Curriculum, is working to define integration of the
basic science curriculum across all four years of UMMS. Also to identify ways the curriculum and basic
sciences are currently integrated. Medical education today has a high level of complexity (which is growing
fast), yet medical students are asked and expected to know it all. And then they are to combine that knowledge
with their own identity and to know who they are as professionals.
Another area where integration is needed is the synthesis of cognitive and moral aspects of the professional
work. To recognize the importance of forming a professional identity and of establishing a moral and ethical
core of service and responsibility, hasn’t been emphasized in the past. This is now being recognized for multiple
levels of patient care professionals, these constructs are important to teach in medical school.
The LCME mandates integration as a requirement of accreditation. They state, “There must be integrated
institutional responsibility for the overall design, management and evaluation of a coherent and coordinated
curriculum.” Evidence of coherence and coordination include the following characteristics:
 Integrated content coordinated and integrated within and across the academic periods of study.
 Horizontal and vertical integration; content is to be integrated within the year and between the years.
 The larger vision is between medical school and graduate medical education
 Curriculum must be good at discreet knowledge pieces and also the area that links it all together must be
emphasized enough.
Patients and consumers (including healthcare systems) also want changes. These constituents are demanding
ethical, critical thinking doctors, who are compassionate and who have developed professionalism. They need
to know all of the scientific literature and how to handle every evidence-based problem they encounter.
Constituents also expect this to be carried out in a fiscally knowledgeable and quality focused manner.
Dr. Chipman spoke about data from a number of national and international educator studies, which illustrates
the advantage medical students experience in learning, when the curriculum has components of integration.
As he gathers more information he is able to identify areas where the UMMS curriculum contains elements of
integration. He reviewed a segment of data from Dr. Minenko’s HD2 course report, measuring course content
and outcomes at the upper tiers of integration. In HD3 a number of her evaluations of students during the
course are linked to the 7 Domains of Competence, which lead her to combine medical knowledge, learning
about patient care with assessing professionalism and other aspects of being a doctor in the first two years,
rather than waiting for year-3 on the wards. Dr. Sanders and Schimmentti also discussed how they have begun
to measure professionalism in their Biochemistry course. One method they’ve identified is to add a 10 minute
clinical correlation in lectures. Their discussion touched on how biochemistry is used in ICU practical
application. These courses demonstrate movement toward integration; there are other areas where this
happening and areas that need to work to move forward.
Dr. Chipman recommends including basic sciences in the clinical curriculum for years 3 and 4, this makes it
possible for students to understand application of the scientific method in the clinical setting. Applying the
scientific method, professionalism and communication skills in year 3 and 4 accomplishes teaching clinical
skills, while reinforcing the need to retain basic sciences and use of the scientific method. Feedback from SFC
members is found in the full discussion.
Scientific Foundations Committee Meeting (SFC)
May 4, 2012
Information
NBME Subject Exam Review sessions
Dr. Woods reported the Subject Exam reviews have been scheduled for all disciplines and offered through
MEDS as faculty development, registration is required. These have been scheduled by Leslie Anderson and
she will continue to remind course directors of dates and times. Some course directors and faculty have
attended the sessions and they have found the time spent to be beneficial for them. The reviews are being held
on the 5th floor of Diehl Hall (above the Biomedical Library), in the AHC Learning Commons, this allows all
attendees at the sessions to participate hands-on for their review.
Medical School Academic Calendars
There have been issues with the calendar information and dates, Dr. Woods is very aware of this situation and
is working directly with staff to in Assessment, Curriculum and Evaluation and Students Learning (all staff
involved with calendars are working together). She is aware that this is of great importance for course director
planning and that accurate information needs to be available early and they must be correct. Dr. Niewoehner
added that in HD1 the course start-date was set to begin a week late, lecturers had already been given their
schedule for teaching and this caused problems. The schedule has been produced out of several offices in
Medical Education and Dr. Woods is still investigating how the calendar was built and how it is impacted by
the UM-TC calendar. The start dates are now the focus of planning by Linda Reilly and Brooke Nesbitt and
will be designed backward for a 5-year period to avoid a similar scenario from occurring. Dr. Woods will
provide an accurate version in the upcoming weeks, once there is certainty that all concerns have been
addressed for Years 1 and 2. She is working to have a complete picture of how the calendar process flows,
course directors will receive complete and accurate information. There will be a web location in the future to
give course directors and faculty access to correct information for a 5-year period. Dr. Woods apologized for
the confusion and reported that course directors would have a corrected electronic version of the calendar as
soon as it is accurate. In the future there will be 2 people who collaborate very closely.
Independent Learning Time
For Year 1 originally there were 4 ILT blocks during the 1st 9 weeks of school, this has changed and there will
be 3 ILT blocks. This will bring both Year 1 & Year 2 in line with each other, both now having 3 blocks. The
ESC has given the go ahead, this is to establish consistency in how ECM timing and scheduling of preceptors.
This will not be used to add curriculum time to the schedule. We can review this in the future if there are
questions or concerns that develop.
Black Bag Training
The schedule for training begins on May 7th and there will be additional dates available, scheduling is designed
to fit course directors timing to make it possible for everyone to get the training they need for their course in a
timely manner. The trainings are required. Course coordinators will also be trained at a later time.
Best Practices
Human Disease Courses
Dr. Niewoehner thanked Kacia Lee (MS-2) for her excellence in communicating the student perspective to SFC
members, as Student Council representative for the class of 2014. During her membership on SFC for AY 201011 and AY 2011-12, Ms Lee has provided highly useful information to the SFC and insight into UMMS medical
students’ educational experience throughout all of the courses medical students are required to take during years
1 and 2.
For the SFC meeting today, Ms Lee provided an overview from the student perspective for best practices in the
HD courses. She reported for students, across HD 1-4 courses there have been very positive experiences in
lecture, in course materials and in course preparation requirements.
Main themes of successful courses:
 Well-organized
 Appropriate level for 2nd year
 Guide students to deeper understanding
Ms Lee noted that the ACR review process identifies course strengths and areas for improvement from the
course directors’ perspective; her presentation talking points are the result of survey to gain feedback from the
class of 2014 medical students for Human Disease 1-4. This is a review of course content, lab practices,
lectures, small group sessions and supplemental materials; and it provides insight for course directors and
faculty. These survey results indicate that HD courses are done very well overall.
Ms Lee’s PowerPoint (with annotated notes) is found at the SFC Moodle site under the May 4th heading.
Annual Course Report
ECM Part 1 and Part 2
Dr. Sharon Allen noted her report will cover ECM 1 and 2; these segments begin in September through March.
The goals and objectives of ECM1are to teach basic interviewing skills, communication and physical exam
skills. An added goal is to begin the process of teaching clinical reasoning. Patients and Populations (P & P) is
also a focus of the course and teaches the role of public health systems. The course is made up of small group
sessions (only), ten students per group who meet once a week.
Assessment is done through on-line anatomy quizzes, an interview practical in November, a written practical at
the end of November, a physical exam practical early in December and P & P is assessed by on-line quizzes.
Professionalism is also a component of the course and is assessed by a facilitator evaluation form completed at
the end of the 18 weeks. All students passed ECM1, “H” were granted to students in the top 3% (23 students)
of performance (they tend to score high on the practicals. A portion of the grade reflects demonstrating
professionalism, participating in small groups, and attending small groups.
Changes that were new for AY 2011-12 include removing 1 communication session and using that time for 1
additional physical exam practice (at the request of students in AY 2010-11) and the Honors grade (“H”) was
added. P&P wasn’t originally in ECM and was added to this course very close to the beginning of Fall 2011.
There were changes to the Hypothesis Driven Physical Exam (HDPE) sessions (method to teach physical exam),
which is used to begin the process of teaching clinical reasoning. Faculty demonstrated the technique for the
first 4 sessions and students then performed this method of examination for the last 3 sessions (at the request of
the 2010-12 Yr-1 class). The HDPE was an evaluative section of the final exam, a change from the previous
year when the facilitator had the opportunity to determine which clinical problem students had addressed in the
course for evaluation. Faculty were recruited, patient educators were trained to present the case, and the students
had the case ahead of the presentation.
Working well:
Integration between ECM and Anatomy, correlation of physical exam with anatomy sequences
Students consider small groups as an excellent way to learn
Anatomy TAs works very well
Moodle has improved
All communication was through Moodle (emails not included)
Radiology was changed to be very anatomy based (appropriate to level of knowledge)
Concerns:
Variance in how faculty facilitators run their small group sessions (especially HDPE)
Radiology poorly attended, held at the end of the day - attempt better timing in the future
Students felt they had already had materials in Anatomy, this was a misinterpretation ECM radiology
covered new material. All sessions were at the end of the course (earlier in semester), correlated with
what dissection in Anatomy
People and Populations wasn’t well rec’d, poorly organized, some content wasn’t presented, quizzes for that
material wasn’t well received, MS thought it was redundant
HDPE was an evaluative of final; students felt it didn’t get at their critical clinical thinking
Next Meeting,
June 1, 2012
.